OBJECTIVE To observe the distribution of pathogens isolated from the endoscopic submucosal dissection(ESD)patients with postoperative pulmonary infections and explore the values of serum C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in prediction of the pulmonary infection.METHODS A total of 246 patients who received ESD in the First Affiliated Hospital of Wenzhou Medical University from Dec.2022 to Dec.2023 were recruited as the research subjects and were divided into the infection group with 50 cases and the non-infection group with 196 cases according to the status of postoperative pulmonary infection.The sputum speci-mens were collected from the patients of the infection group,the isolated pathogens were identified.The risk fac-tors for the postoperative pulmonary infection in the ESD patients were analyzed.The levels of serum CRP,IL-6 and PCT were compared between the infection group and the non-infection group.The values of the indexes in pre-diction of the postoperative pulmonary infection in the ESD patients were observed.RESULTS Totally 67 strains of pathogens were isolated from the 50 patients with infection,21(31.34％)of which were gram-positive bacteria,37(55.22％)were gram-negative bacteria,and 9(13.43％)were fungi.The no less than 60 years of age(OR=4.785),complication with diabetes mellitus(OR=20.627),operation duration no less than 60 min(OR=19.643)and bedridden time no less than1 week(OR=38.641)were the risk factors for the postoperative pulmonary infec-tion in the ESD patients(P＜0.05).There were significant differences in the levels of serum CRP,IL-6 and PCT between the infection group and the non-infection group(P＜0.05).The sensitivity of the joint detection of serum CRP,IL-6 and PCT was 96.00％in prediction of the postoperative pulmonary infection in the ESD patients,with the specificity 83.67％,the AUC value 0.898,which were superior to the single detection of CRP,IL-6 and PCT(P＜0.05).CONCLUSIONS The ESD patients are at high risk of postoperative pulmonary infection.The gram-negative bacteria are dominant among the pathogens.There are a variety of influencing factors for the postopera-tive pulmonary infection in the ESD patients.The CRP,IL-6 and PCT have certain values in prediction of the postoperative pulmonary infection in the ESD patients.

OBJECTIVE To observe the distribution of pathogens isolated from the endoscopic submucosal dissection(ESD)patients with postoperative pulmonary infections and explore the values of serum C-reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in prediction of the pulmonary infection.METHODS A total of 246 patients who received ESD in the First Affiliated Hospital of Wenzhou Medical University from Dec.2022 to Dec.2023 were recruited as the research subjects and were divided into the infection group with 50 cases and the non-infection group with 196 cases according to the status of postoperative pulmonary infection.The sputum speci-mens were collected from the patients of the infection group,the isolated pathogens were identified.The risk fac-tors for the postoperative pulmonary infection in the ESD patients were analyzed.The levels of serum CRP,IL-6 and PCT were compared between the infection group and the non-infection group.The values of the indexes in pre-diction of the postoperative pulmonary infection in the ESD patients were observed.RESULTS Totally 67 strains of pathogens were isolated from the 50 patients with infection,21(31.34％)of which were gram-positive bacteria,37(55.22％)were gram-negative bacteria,and 9(13.43％)were fungi.The no less than 60 years of age(OR=4.785),complication with diabetes mellitus(OR=20.627),operation duration no less than 60 min(OR=19.643)and bedridden time no less than1 week(OR=38.641)were the risk factors for the postoperative pulmonary infec-tion in the ESD patients(P＜0.05).There were significant differences in the levels of serum CRP,IL-6 and PCT between the infection group and the non-infection group(P＜0.05).The sensitivity of the joint detection of serum CRP,IL-6 and PCT was 96.00％in prediction of the postoperative pulmonary infection in the ESD patients,with the specificity 83.67％,the AUC value 0.898,which were superior to the single detection of CRP,IL-6 and PCT(P＜0.05).CONCLUSIONS The ESD patients are at high risk of postoperative pulmonary infection.The gram-negative bacteria are dominant among the pathogens.There are a variety of influencing factors for the postopera-tive pulmonary infection in the ESD patients.The CRP,IL-6 and PCT have certain values in prediction of the postoperative pulmonary infection in the ESD patients.

Objective:To investigate the role of mitofusion 2 (Mfn2) in high glucose (HG)-induced endoplasmic reticulum stress (ERS) and apoptosis of podocytes.Methods:(1) Streptozocin was used to induce a diabetes mellitus (DM) rat model. Renal histopathological changes in rats were observed by HE staining. Expression of Mfn2 and CCAAT/enhancer-binding protein homologous protein (CHOP) in glomeruli was observed by immunohistochemistry. Protein levels of Mfn2, protein kinase RNA-like ER kinase (PERK), phospho(p)-PERK, and CHOP in glomeruli were analyzed by Western blotting. (2) Conditionally immortalized human podocytes (HPC) cultured in vitro were divided into control, mannitol (MA) and HG groups. Expression of Mfn2 was observed by immunofluorescence. Protein levels of Mfn2, p-PERK, PERK and CHOP in HPC were analyzed by Western blotting. Podocyte apoptosis in each group was evaluated by flow cytometry with AnnexinⅤ-PE/7AAD double staining method. (3) HPC were divided into control, HG, HG+Mfn2-Myc plasmid-transfected and HG+control plasmid-transfected groups. Protein levels of Mfn2, p-PERK, PERK and CHOP in HPC were analyzed by Western blotting. Expression of CHOP was observed by immunofluorescence. Mitochondrial membrane potential in each group was observed by mitochondrial membrane potential assay kit with JC-1. Podocyte apoptosis in each group was evaluated by flow cytometry with AnnexinⅤ-PE/7AAD double staining method. Results:(1) Compared with the control group, the glomerular mesangial matrix of the DM group rats was significantly proliferated, and the expression of Mfn2 was down-regulated with the expression of ERS-related proteins p-PERK/PERK and CHOP up-regulated (all P<0.05). (2) Compared with the control group, Mfn2 was down-regulated and p-PERK/PERK and CHOP were up-regulated in HPC of HG group (all P<0.05). Apoptosis of HPC was also increased in HG group. There was no significant difference in the above indicators between the control group and the mannitol group (all P>0.05). (3) Compared with the HG group, mitochondrial membrane potential of HPC was alleviated and apoptosis of HPC was decreased in HG+Mfn2-Myc plasmid-transfected group ( P<0.05). P-PERK/PERK and CHOP were down-regulated in HG+Mfn2-Myc plasmid-transfected group (both P<0.05). There was no significant difference in the above indicators between the HG group and the HG+control plasmid-transfected group (all P>0.05). Conclusions:Mfn2 down-regulation in HG-stimulated podocytes may induce ERS to increase apoptosis of podocytes. Up-regulation of Mfn2 can alleviate the HG-induced ERS and apoptosis in podocytes.